- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,535.20 / $22,464.40 / $34,187.00
| Facility | | $16,535.20 | $22,464.40 | $34,187.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,197.23 / $20,180.09 / $29,877.16
| Facility | | $13,197.23 | $20,180.09 | $29,877.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,893.16 / $19,824.20 / $39,648.40
| Facility | | $13,893.16 | $19,824.20 | $39,648.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $208.33 / $370.78
| Facility | | $144.00 | $208.33 | $370.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,766.00 / $19,622.34 / $33,666.90
| Facility | | $1,766.00 | $19,622.34 | $33,666.90 |